Fainting
Face to Face Consultation
Book amber appointment
Book a red appointment if:
The faint/collapse happened when sitting or lying down (not in standing position)
there was loss of consciousness lasting >1 minute
If it is a recurrent issue
Consider directing to A&E/999 if more serious symptoms as listed here
Falls Elderly
Face to Face Consultation
Book a green appointment unless the below
If the patient is calling due to a fall that has just happened, or has suffered an injury due to a fall, ask them to immediately call 999, or do that for them if they are alone.
Fatigue / Tiredness
Refer to Community Pharmacy or Face to Face consultation
Book a green appointment.
If related to poor sleep/insomnia – see sleeping difficulties or insomnia guidance.
Signpost website Support:
Fever
Face to Face consultation
Ask further questions to determine if any other symptoms and see the relevant page,
Book a red appointment if they report a fever with no clear cause
Fertility Issues
Face to Face Consultation
Book green appointment
Fit Note
Face to Face Consultation
New episode: Advise patients to self-certify for 7 days (unless current guidelines state otherwise).
Further information and self-certification form available on the gov.uk website.
After 7 days: If the patient has had a consultation with a GP or has a clinical document relating to the problem on file then send a request for a sick note to the duty clinician.
If no evidence in the records of the patient will need a green appointment after the 7 day self-certificate ends (clinicians can backdate a fit note but not forward date)
Flu
Community Pharmacy or Face to Face Consultation
Antibiotics do not work for viral infections such as flu.
Consider ARI Hub if the patient has a cough
Send patients to pharmacy for advice and product purchase.
Advise patients most people will start to improve without treatment within 1-2 weeks but some symptoms may last longer.
If patient is not improving within 1-2 weeks, is getting worse or has red flags as per ‘chest infection‘ book a red appointment
Food poisoning
Refer to Community Pharmacy or Face to Face Consultation
Send patients to pharmacy for advice and product purchase.
See guidance for Diarrhoea & Vomiting under ‘D‘.
Foot Pain
Musculoskeletal Specialist (16 years and over)
Book appointment with the MSK specialist, or signpost to self-referral option.
If the pain started after recent trauma advise to attend urgent care / A&E.
If patient is under 14 years please book a telephone consult with a clinician
Care
If the patient is not coping with current pain levels and/or there are ‘medical’ causes for the pain or if they are under 16 years of age book a face to face appointment with a clinician.
Book a same day face to face appointment if there is a possible infected joint (i.e. sudden severe joint pain, feverish, new red hot swollen joint)
Ensure there are no other ‘medical’ causes for the pain: If there are then book in a telephone consultation with a clinician instead.
Frozen Shoulder
Musculoskeletal Specialist (16 years and over)
Book appointment with the MSK specialist, or signpost to self-referral option.
If the pain started after recent trauma advise to attend urgent care / A&E.
If patient is under 14 years please book a telephone consult with a clinician
Care
If the patient is not coping with current pain levels and/or there are ‘medical’ causes for the pain or if they are under 16 years of age book a face to face appointment with a clinician.
Book a same day face to face appointment if there is a possible infected joint (i.e. sudden severe joint pain, feverish, new red hot swollen joint)
Ensure there are no other ‘medical’ causes for the pain: If there are then book in a telephone consultation with a clinician instead.
Fungal Nail Infection
Community Pharmacy or Face to Face Appointment
Send patients to the pharmacy for advice and product purchase. Advise patients topical treatments can take up to 12 months of use to cure the infection.
If OTC treatments have been tried, ask the patient to provide a nail clipping to be sent for culture. Once results are available to book a consultation with a GP/ANP to discuss.
Pins & Needles / Arm / Face Numbness
Triage Symptoms First
- Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.
- Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
- Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.
- Time – it’s time to dial 999 immediately if you notice any of these signs or symptoms.
- Complete paralysis of 1 side of the body
- Ask the person to stick out their tongue. If the tongue is crooked’ if it goes to one side or the other
- Sudden loss or blurring of vision
- Dizziness
- Confusion
- Difficulty understanding what others are saying
- Problems with balance and co-ordination
- Difficulty swallowing (dysphagia)
- A sudden and very severe headache resulting in a blinding pain unlike anything experienced before.
- Loss of consciousness
If anyone is with the patient at home ask them to call 999 immediately.
Send a task message to the clinical team advising them of the patient situation.
If no one is at home with the patient, ask a colleague to call 999 for you whilst you remain on the phone with the patient.
Bring the call to the attention of your supervisor.
Book face to face appointment within a week.
Book appointment.
Swollen Feet / Legs / Ankles
Face to face Consultation
Book a green face to face appointment.
Book a red face to face appointment if they have:
- A single leg (particularly calf swelling) has become swollen especially if sudden onset/recent long haul flight
- Associated with difficulty in breathing
- Associated with chest pain
Weakness of Limbs or Face
Triage Symptoms First
- Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.
- Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
- Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.
- Time – it’s time to dial 999 immediately if you notice any of these signs or symptoms.
- Complete paralysis of 1 side of the body
- Ask the person to stick out their tongue. If the tongue is crooked’ if it goes to one side or the other
- Sudden loss or blurring of vision
- Dizziness
- Confusion
- Difficulty understanding what others are saying
- Problems with balance and co-ordination
- Difficulty swallowing (dysphagia)
- A sudden and very severe headache resulting in a blinding pain unlike anything experienced before.
- Loss of consciousness
If anyone is with the patient at home ask them to call 999 immediately.
Send a task message to the clinical team advising them of the patient situation.
If no one is at home with the patient, ask a colleague to call 999 for you whilst you remain on the phone with the patient.
Bring the call to the attention of your supervisor.
Book face to face appointment within a week.
Book appointment.